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Friday, February 26, 2010

The Centers for Disease Control and Prevention estimates that at least 1,350 college students commit suicide each year. This makes suicide the second leading cause of death among college students. Accidents is the number one cause of death. A recent conference at Rutgers University was organized around the idea that "universities must confront the problem of student suicides and address mental health and substance abuse problems rather than wait until it's too late."

A local psychologist and colleague, Alan Siegel, spoke at the conference about mental health services at MIT. He spoke about the steps that the university made to make its mental health program better known among students and increasing the ease of access. A lawyer spoke about the liability that universities can potentially incur when the institution reacts to students who are suicidal by suspending or dismissing them without providing any means of help.

Are you a college student reading this? Perhaps an administrator? How can you help? Educate yourself about the possible warning signs of suicide. Consult with your college counseling center to learn more about what resources are available both on and off campus for someone in need.

Finally, some evidence that suggests my interest in viewing YouTube clips is a worthy endeavor. An Irish newspaper reported that YouTube clips are being used in reminiscence therapy sessions for patients with dementia. Patients at a nursing home are shown old clips of familiar singers, movies, and other types of entertainment. The patients are engaged with familiar memories and have an opportunity to share with each other.

I didn't know about Charlie Lord until I heard his obituary on NPR. Charlie was a Quaker and a conscientious objector. He was assigned by the federal government to work in a state mental hospital in Pennsylvania. He smuggled in a camera and took haunting photos of the psychiatric ward. These images are graphic and disturbing. Be thoughtful about your own feelings before you click on this link to view them.

This story, and his photographs, are an important reminder to me that it is incumbent upon us to protect those among us who are unable to protect themselves.

Wednesday, February 24, 2010

After spending nearly two frustrated hours on the phone this past Monday with an insurance company I came to an important realization. Those who don't support health insurance reform clearly have not ever contacted a health insurance company.

Here is the short story. Pay close attention as it's confusing. Insurance company A sent a claim to their subcontractor (company B) . Company B contacted me and left a voice mail. I called back five times and never got a return call. On the sixth call they told me the person I was calling was no longer with company B. They informed me the claim was closed and sent back to company A because company B only deals with in-network insurance claims and I am an out of network provider. I would have to contact company A. Company A told me that I should have never called company B. I actually needed to call company C. A provided me the number for company C. I called that number to find out that it was disconnected. Back on the phone to company A. This time A told me that I should have never been given the number to company C. A asked me to call B and get documentation. B previously said I needed to call A as B could give me no documentation. A offered to re-submit the claim, telling me that A's adjusters would again send the claim to B. B would again reject the claim and send it back to A because B isn't supposed to deal with my claims. Company A told me that was all they could do.

Sound crazy? That's because it is crazy.

I then engaged in my own version of a filibuster and refuse to stop talking until the provider relations representative for company A transfers me to a supervisor. Supervisor apologizes for any inconvenience and promises to solve the problem and call back by 11 am on Tuesday.

It's Wednesday now and I'm still waiting by the phone with baited breath.

I'm sufficiently motivated to write a more detailed letter to my senator, congressional representative, and the Commonwealth's Insurance Commission. Are you? Have you spoken up about the problems you have encountered with your health insurance?

Contact your elected representatives in congress to complain. Share your story here if you'd like.

Friday, February 19, 2010

I have frequently thought about volunteering for a disaster relief organization as a psychology. Every time I think about it, I remember what I learned in graduate school: critical incident stress debriefing has been shown to be ineffective and can possibly be harmful. That's certainly not something that I want to do.

Research from 9/11 has suggested than when relief workers engage survivors in critical incident stress debriefing, having individuals rehash their traumatic experiences, more harm was done than good: instead of preventing PTSD this type of counseling provoked it. What is the suggested intervention? Research and experience suggest that interventions that focus on promoting a sense of safety, calmness, and a sense of agency, connectedness, and hope are most effective.

Every wonder why some music, regardless of the vocals, makes you happy while other tunes make you sad? I thought I learned the answer to that from my third grade music teacher. While playing the xylophone I learned that music in the major key was happy and music in the minor key was sad. For the next 15 years of trumpet, horn, violin, and piano lessons I didn't question it again.

Silly me.

Understanding why this is so is a little more complicated. Part of the more complicated answer involves our use of language: patterns of pitches in major keys mirror the patterns of exited speech. Music in minor keys mirror speech that is more subdued. Check out the article if you want to know more.

"Think of it as a door, a door that is going to open up onto a whole new world for you."

I've not been able to stop talking about this movie since I watched it last week. What I like, is the stunning way the movie is able to take the inner-experience of Temple Grandin and create a visual experience so other's can see the world from a new perspective. Clicking on the link will take you to a promo to the movie.

Thursday, February 18, 2010

In a historic event, Maggie the therapy dog and Dr. Freud met to consult on a case. Before agreeing to disagree, Maggie growled, tweaked Freud's nose, and buried his glasses in the corner of a chair. If you are curious about Maggie and her work, be sure to check out her blog: www.therapydogblog.blogspot.com

Monday, February 15, 2010

I recently had an e-mail correspondence with my dissertation chair that brought back some fond memories. A particular day is still very clear in my mind: I was so excited thinking I was going to learn something new. My chair, Susan Hawes, had sent me back a draft of my dissertation with comments. I was reading my methodology section. I thought it was pretty good: being a good doctoral student I was very interested in matters of epistemology and ontology. In retrospect I was getting carried away with my own geek-like cleverness.

In the margin on a particular page there was a single word written and underlined. Tautology. "Great," I thought. I was so excited. There was some new intellectual puzzle for me to ponder and think about. Of course, as was frequently the case with Susan, I had no idea what she was talking about. She's the kind of professor who (at the time) seemed both brilliant and totally unintelligible.

I drove the 60+ miles home eager to think new deep philosophical thoughts. While I didn't know what the word tautology meant, I knew it was the study of something. Must be good, right?

Imagine my surprise when I got home and looked the word up. An unnecessary or unessential repetition of meaning, using different and dissimilar words that effectively say the same thing twice. I was mortified, of course. Mortified both because I was such a geek thinking I was going to get to be all smart and because I had written a chapter of my dissertation in which I went on and on about the same thing. This of course wasn't new feedback to me: my advisor for my masters thesis once wrote a comment saying "I'm reminded of a dog tied to a stake running around and around in a circle tearing up all the grass."

Some lessons take time to learn, don't they?

Anyway, back to my point. I clicked on a few links in our e-mails and went to some of Susan's websites (here, here, and here). Imagine my surprise when I was able to actually understand what she was writing about. She is no long unintelligible. Now she just seems brilliant to me. That's progress.

This has all gotten me to go way back into my education and think about the nature of learning and wisdom. I started college when I was 16. I of course thought I knew everything. I promptly got put into my place and received (I think) a D in my first every class, which was philosophy. Whoops.

Two years later, a Junior in college, the situation had improved. I thought it was so clever of me when I understood what my history and systems of psychology teacher said: the older we get the more we know what we don't know. I was clever, perhaps, but didn't really get what he was saying. Lost in the nature of my own cleverness, I was amused that I was so smart I understood him when I was 18. I failed to reflect on the very humble nature of what he was talking about.

And then of course there was Susan, almost fifteen years later, reminding me how much more there was for me to learn about what I didn't know.

I was always in such a rush. I'm not rushing so much anymore because every time I do I'm reminded how little I actually know. It's also rather unsettling to keep on learning new things and discovering how little I actually know about anything.

It's this rushing that I think is a larger problem. I can't turn the television on without seeing an add promising a quick fix for a problem, a faster path to financial freedom, and now even an education in "less time than ever before." Mirroring the world at large, psychology seems to be after a quick fix too. The field wants to create technologies that fix depression faster, resolve the sequela of trauma in the fewest sessions possible, and end panic and anxiety in six sessions of cost-effective cognitive behavioral group therapy.

I don't think these endeavors are bad: there is a lot of human suffering and humanity needs lots of tools to help address these situations. I worry about the unintended costs of all this rushing. Learning--and wisdom--take time. It's not that we learning something once and are done with it. We go over and over the same things countless times. Repeating them in different contexts, different levels, and from different perspectives.

Friday, February 12, 2010

During my graduate training I frequently was told that I shouldn't take a direct stand on spanking and corporal punishment. It was suggested that taking a direct stand might be judgmental, might not be respectful of different choices about child-rearing, might not tolerant or understanding of religious views, etc.

In a recent statement from an the American Psychological Association task force, it was concluded that "parents and caregivers should reduce and potentially eliminate their use of any physical punishment as a disciplinary measure." Some things never change: the APA isn't taking a direct stand. One wouldn't want to appear to be judgmental or disrespectful.

The release goes on to find strong correlations between physical punishment and an increase in childhood anxiety and depression, and increase in behavioral problems, including aggression, and impaired cognitive development--even when the child's pre-punishment behavior and development were taken into consideration.

Muarry Straus, a professor at the University of New Hampshire, points out that while the evidence is correlational--not proof, the association is "more robust and stronger than the correlations that have served as bases for other public health interventions, such as secondhand smoke's relation to cancer, exposure to lead and IQ scores in children, and exposure to asbestos and laryngeal cancer."

Here are a few interesting facts, a survey from 2000 indicates that corporal punishment of minors within the home is lawful in all 50 states of the US, has been outlawed in 25 countries around the world, is legal in schools in 20 US states, and outlawed in schools in countries including Canada, Japan, South Africa, New Zealand, and nearly all of Europe except the Czech Republic and France.

Interestingly, corporal punishment is banned in most juvenile correction facilities in the US yet continues in public schools. Why? In 1977 the Supreme Court found that the Eighth Amendment only protects convicted criminals from cruel and unusual punishment--not children in a classroom. A Time magazine article from 2009 wrote that "Texas paddles the most students in the nation, as well as the most students with disabilities.... Nationwide, students with disabilities are paddled at more than twice the rate of the general student population.

Interesting.

I too wish not to be disrespectful. However despite my training, I'm going to go ahead and be judgmental. I think spanking is wrong and that it isn't a useful from of discipline.

There are many other forms of effective parenting--forms that are much more effective that do not involve hitting children. These aren't easy parenting tools. They take time, they take planning, they take education, and they take the development of a ongoing relationship with a child. They are important. I like teaching them and seeing a child blossom and grow--and I equally enjoy seeing the children's parents blossom and grow.

Wednesday, February 10, 2010

Now here is a workout that you probably won't be able to get at your local gym: a nostalgia workout. A recent BBC News article said that "nostalgia can give meaning to our seemingly dull lives."

Why do we care about our first car, kiss, or visit to the ocean? Some psychologists have pointed out that we care because nostalgia makes us feel good. Once considered a sickness (the word comes from the Greek "nostos"--return--and "algos" --pain). Modern day researchers have found that remembering past times improves mood, increases self-esteem, strengthens social bonds, and imbues life with meaning.

"Nostalgia," says a researcher from London, "is a way for us to tap into the past experiences that we have that are quite meaningful--to remind us that our lives are worthwhile, that we are people of value, that we have good relationships, that we are happy and that life has some sense of purpose or meaning."

A lot of times clients come to me with painful nostalgia. Negative feelings from the past--perhaps times they were bullied, painful relationships, or abandonment by others. This isn't the nostalgia I'm writing about here. This nostalgia is about positive life changing experiences.

Here's the workout. Routledge, the researcher from England, says that people who practice this Nostalgia workout for five minutes a day have a significant increase in psychological well-being, feel more alive and energetic, and see there life as more worthwhile.

So, rather than practicing negative nostalgia today, how about trying a different practice?

list cherished memories

find photos or mementos from happy times

close your eyes and think about what is outside the "picture frame" to conjure subtle details

reminiscing with people from your past strengthens relationships

take mental snapshots and save mementos of happy times for future nostalgia

Saturday, February 6, 2010

In a recent press release from the American Heart Association, a research report from the Journal of the American Heart Association was released. A study found that every hour spent in front of the television per day brings with it an 11 percent greater risk of premature death from all causes, and an 18 percent greater risk from dying from cardiovascular disease. The findings apply to both obese and overweight people as well as people with a healthy weight because prolonged periods of sitting have an unhealthy influence on blood sugar and blood fat levels.

Keep in mind that this isn't just sitting at the TV--this includes sitting at your desk, too.

A University of London study done for Hewlett-Packard found that "infomania"--a term connected with addiction to email and texting--can lower your IQ by twice as much as smoking marijuana. Moreover, email can raise the levels of noradrenaline and dopamine in your brain by constantly introducing new stimuli into your day. When those levels get too high, complex thinking becomes more difficult, making it harder to make decision and solve problems. The article gives several suggestions: take control of email, prioritize your prioritizing, blind-side the date (approach it form an unexpected direction), do less, and unplug.

A study published by Ohio State University researchers in Psychosomatic Medicine showed that women who routinely practiced yoga had lower amounts of the cytokine interleukin-6 (IL-6) in their blood. IL-6 is an important part of the body's inflammatory response. It has been implicated in heart disease, stroke, type-2 diabetes, arthritis and a variety of other age-related debilitating diseases. Reducing inflammation may provide substantial short and long-term health benefits.

Monday, February 1, 2010

One of my favorite memories of my post-doctoral training was our weekly mindfulness exercise. Every Thursday afternoon during the consultation team meeting the first ten minutes would be spent doing some sort of interesting activity. Some exercises were silly (mindfully feed each other orange juice) while others were horrible (read graphic deceptions of awful stuff and be mindful of our reactions without actually reacting). The one that I looked most forward to was one that we often did in the autumn or spring. We would go outside and mindfully walk while being aware of things that represented both seasons (snow and a plant with buds, green leaves on a tree with another changing colors). This was especially nice since the offices were all in a windowless basement. I relished having the opportunity to get outside.

What's mindfulness? There are a variety of definitions. The simplest, and my personal favorite, comes from John Kabat-Zinn. He writes that "mindfulness means paying attention in a particular way; on purpose, in the present moment, and non-judgmentally. That's all. Nothing more, nothing less. You can make mindfulness into an elaborate practice (there are many systematic forms of meditation that do this) or can make it into something very simple (though, once you try, you'll find how deceptively simple it is to just pay attention, without judgement, to what you are experiencing in the moment).

What's so good about mindfulness? It teaches us to pay attention to what is--what is right in front of us and what is happening in the moment. Practicing mindfulness frees us from becoming entangled in a mass of thoughts about what already happened (the past) and worries about what might happen (the future). In doing this practice, you can learn the counters of how you think, how you get in your own way, and how the very nature of your thoughts can cause needless suffering. Though this practice you can learn to distinguish observations from judgments, the transitory nature of feelings, and how to experience the present moment in all of its fullness.

Today is the first day of February. I'm in New England. There isn't a whole lot of examples a season other than winter. While I was walking Maggie today I got interested in areas where there was both lightness and dark. She and I searched out these contrasts and I captured some of the images with my mobile phone. That became my mindfulness activity. Each time I noticed my mind thinking about something else (which was frequent, between my own distractions and those that Maggie provided) I gently turned my mind away from the thought and returned to looking for areas that were both light and dark.

Try it out yourself. Go for a walk today and be aware of what you see. Where do you see the contrast between lightness and dark. Can you be aware of your thoughts when you are walking? When you start thinking of other things--your grocery list, what's for lunch, whether there is going to be traffic, etc.--gently turn your mind away from those thoughts and return to your quest for finding examples of both lightness and dark. Can you do the same with your thoughts? Can you see both lightness and dark in what you are thinking?